剪切波弹性成像评估宫颈上皮内瘤变患者宫颈锥切术后宫颈硬度变化的研究

Investigation of shear wave elastography in evaluating cervical elasticity of cervical intraepithelial neoplasia patients after cervical conization

目的:利用剪切波弹性成像技术(SWE)评估高级别宫颈上皮内瘤变(CIN)患者宫颈锥切术后宫颈硬度及宫颈长度变化特点。方法:选取2020年9月—2022年1月于我院行宫颈锥切术后半年内的育龄患者50例(锥切组),选取同期确诊为高级别CIN患者50例(CIN组)及宫颈体检正常者50例(正常组),采用SWE技术分别测量各组宫颈四个位点(宫颈内口前、后唇及外口前、后唇)硬度,比较分析各组间宫颈硬度及CL的差异。结果:宫颈锥切术后半年内宫颈硬度无明显变化(P>0.05);正常组宫颈内口硬度高于宫颈外口(P<0.05);锥切组内宫颈内口后唇硬度高于外口后唇(P<0.05);锥切组宫颈四个位点的硬度均高于CIN组及正常组(均P<0.05);CIN组宫颈外口后唇硬度高于正常组(P<0.05);大锥切组宫颈内口后唇及外口后唇硬度均低于小锥切组(P<0.05);锥切组的宫颈长度低于正常组(P<0.05)。结论:SWE技术测得CIN患者宫颈锥切术后宫颈硬度增高,宫颈长度缩短,SWE技术可以作为评价宫颈硬度的工具。

Objective:To evaluate the changes of cervical elasticity and cervical length after cervical conization in patients with high-grade cervical intraepithelial neoplasia(CIN)by shear wave elastography(SWE).Methods:Fifty patients who underwent cervical conization within half a year(conization group),50 patients who were diagnosed with high-grade CIN(CIN group)and 50 patients with normal cervical physical examination(normal group)were selected in our hospital from September2020 to January 2022.Elasticity were obtained at the internal and external os in the anterior and posterior portions of the cervix using a transvaginal SWE approach in each group,and the differences in cervical elasticity and CL among the groups were compared.Results:There was no significant difference in cervical elasticity after conization within half a year(P>0.05).The elasticity of the cervical internal os was higher than that of the external os in the normal group(P<0.05).The elasticity of the posterior portions of the cervical internal os was higher than that of the external os in the conization group(P<0.05).The cervical elasticity of four sites in the conization group increased compared with other two groups(P<0.05).The elasticity of the posterior portions of the cervical external os in the CIN group was higher than that in the normal group(P<0.05).The elasticity of the posterior portions of the cervical internal os and the external os in the larger conization group were lower than those in the smaller conization group(P<0.05).The cervical length of the conization group was lower than that of the normal group(P<0.05).Conclusion:Cervical elasticity increases and cervical length decreases in CIN patients after cervical conization by SWE,and SWE can be used as a tool to evaluate cervical elasticity.